Authors (including presenting author) :
Ho PS (1), Chiang SM (1), Law WK (1), Wong MC(1)
Affiliation :
(1) Clinical Oncology, Tuen Mun Hospital
Introduction :
Extravasation injury (EI) remains the most common iatrogenic complication in oncology chemotherapy patients resulting in pain, skin necrosis, nerve damage, scarring, or even permanent contracture especially in vesicant agent.
Due to the potential risks and harms of extravasation, an evidence based clinical practice was developed and implemented to enhance visibility of vein to decrease chance of failure puncture and decrease the number of venipuncture.
Objectives :
(1) To promote/educate repetitive squeezing stress ball at home for oncology patients who were receiving chemotherapy in day center.
(2) To encourage repetitive squeezing stress ball for 1 min before intravascular catheter insertion to all patients who receiving vesicant chemotherapy.
Methodology :
A verbal instruction and demonstration by nurses were given for all patients to educate how to do and the rationale of the exercise, the other measurements also mentioned, e.g. encourage fluid intake, lifestyle improvement to enhance their vein condition e.g. increase visibility and elasticity. A group of patient who is receiving vesicant agents will be selected for doing this 1-min exercise in day chemotherapy center before venipuncture by the chemotherapy nurse injector. They would be squeezing the same size, some elasticity ball. A face to face education also will provide by this group of patient since they have a high risk and more iatrogenic complication of the chemotherapy agents.
Result & Outcome :
143 patients within 2 months for carried out 1-min squeezing ball exercise. No extravasation incident was reported and near 85% patients was first attempt successful in venipuncture. Also positive feedback from all patients and the chemotherapy injectors were collected. Knowledge of the ways for increasing vein visibility and elasticity was noticed. Also awareness of the vein condition was enhanced after the verbalize information given. Conclusion The squeezing ball exercise was effective in increasing the visibility and accessibility of vein, and decreasing the number of time in venipuncture attempt in chemotherapy patient. Continues prompting this exercise will be benefit for those chemotherapy patients during venipuncture.
